Health Glossary: ​​Serotonin Syndrome

Serotonin syndrome – the excess of happiness hormones

If you believe women’s magazines, you can’t get enough of the feel-good hormone serotonin. It ensures a balanced mood, regulates hunger and controls many important messenger substances that ensure a pleasant emotional state. But if too much serotonin accumulates in the body, serious problems can arise. Then one speaks of a serotonin syndrome.

What is serotonin syndrome?

Serotonin is a very important neurotransmitter. It stimulates the central as well as the peripheral nervous system. Serotonin is vital. However, if there is an abnormal accumulation of the hormone in the body, one speaks of a serotonin syndrome. It is a complex clinical picture. It often remains undetected because it is made up of a large number of cognitive, autonomous or neuromotor defects as well as changes in behavior patterns. The serotonin excess can not only cause slight problems that even those affected hardly notice, but also take on life-threatening forms.

causes

There are two possible triggers of serotonin syndrome: either the disease is caused by a certain drug overdose or it is due to negative interactions between different drugs. It is common to treat depressed patients with drugs that stimulate or increase the release of serotonin in the brain (tryptophan, MDMAs, amphetamines). If these drugs are readily prescribed in high doses, acute serotonin accumulation can occur. Other drugs inhibit the breakdown of serotonin in the body (e.g. serotonin-norepinephrine reuptake inhibitors). If such drug groups are combined with one another, interactions can occur.

symptoms

The symptoms are divided into three areas: Autonomous vegetative symptoms include, for example, an increase in pulse rate and blood pressure, excessive sweating, diarrhea, rapid breathing, headache, an undifferentiated feeling of flu and dilation of the pupils. In addition, central nervous arousal symptoms can also appear. These include hallucinations, impaired consciousness, coordination disorders, restlessness (cannot remain still) or reduced drive. Physical signs can also occur. These manifest themselves in increased reflexes, seizures and cramps, rapid and involuntary muscle twitches or a high tremor (rhythmic tremor).

diagnosis

The clinical picture cannot yet be diagnosed using laboratory parameters (blood count or urine). Only good observation from a doctor can make a diagnosis. Recognizing serotonin syndrome is particularly problematic because the symptoms are so ambiguous and sometimes quite inconspicuous. For example, a patient is sometimes regarded as a simulant, especially in the initial stages. Most symptoms appear (in mild form) just a few hours after taking the drug groups mentioned. Therefore, it makes sense to consult a doctor at short notice in case of doubt.

treatment

If the doctor recognizes the symptoms correctly and combines them to make a correct diagnosis, the possible preparations must be discontinued immediately. However, this can lead to further follow-up problems, because the funds were finally prescribed for a reason. Since there is still no uniform treatment pattern for serotonin syndrome, the current move is often to stop taking all medication and to monitor the patient first (inpatient). In some cases, inhibitory drugs are administered, which in turn are intended to reduce serotonin levels. Sedatives are also used regularly.

Important NOTE: This article cannot replace a visit to the doctor. It only contains general information and should therefore never be used for self-diagnosis or self-treatment.